Introduction
A herniated disc, i.e. the displacement of the gelatinous nucleus (nucleus pulopsus) of an intervertebral disc (discus intervertebralis) into the spinal canal where the spinal cord runs, is one of the most common diseases of the spine. A herniated disc becomes problematic when nerve root compression occurs. In this case, the herniated disc can cause numbness and restrictions in mobility (motor failure symptoms). Theoretically, a herniated disc can affect anyone, therefore pregnant women are also affected by the disease. During pregnancy, herniated disks often occur from the third month of pregnancy onwards, they can theoretically affect any part of the spine, but the most common are herniated disks in the lumbar spine, less frequently there are also herniated disks in the cervical spine.
Causes
For a herniated disc to occur, the outer fibrous ring that holds the disc in its actual position must be weakened or damaged. Such damage can occur when lifting extremely heavy loads, for example. But also genetic weaknesses of the fibrous ring can lead to a herniated disc without an obvious cause.
Especially during pregnancy, however, the hormonal changes in a woman’s body are the primary cause of an increased risk of suffering a slipped disc during pregnancy. Hormones such as progesterone or oestrogen, which are increasingly produced during pregnancy, not only affect the uterus, ovaries and the formation and maintenance of the placenta, but also prepare the ligaments and bony structures of the female pelvis for the forthcoming birth. In the pelvis, for example, progesterone has a relaxing effect on the pubic symphysis.
This connection between the two pubic bones is loosened by the action of the hormones in order to widen the pelvis even more at birth and allow the child to pass through the birth canal. Unfortunately, the hormone not only affects the connective tissue of the pubic symphysis, but also the fibrous rings of the intervertebral discs, which consist of connective tissue. Therefore, even low levels of stress can lead to a slipped disc during pregnancy. In addition to the hormonal changes, the increasing weight of the growing child also places an enormous strain on the spine.
Symptoms
The main symptom of a slipped disc during pregnancy is severe pain. If the spinal cord is affected by the displaced disc nucleus, paralysis and sensitivity disorders occur in addition to the pain. The pain often starts suddenly, mostly under stress, and the affected persons quickly adopt a so-called relieving posture.
A relieving posture refers to the position in which the pain is bearable. Movement aggravates the pain symptoms, sometimes patients are no longer able to walk independently. In the worst case, this can lead to urinary and fecal incontinence, which is accompanied by sensitivity disorders in the genital area.
Such failure symptoms are an emergency and require surgery. The symptoms of a herniated disc differ according to the region where the herniated disc is present (cervical, thoracic or lumbar spine). The symptoms are the same in an existing pregnancy as if there was no pregnancy. However, the symptoms are aggravated by the increased weight of the pregnant woman, which puts a strain on the spine.
